Gynaecologic Oncology Society of Kenya (GOSK) clinical management protocol for endometrial carcinoma in Kenya - 2026
DOI:
https://doi.org/10.59692/1ws77m54Keywords:
Clear-cell carcinoma, Endometrial neoplasms, Endometrical carcinomaAbstract
Objective: To establish a standardized, evidence-based approach to the management of endometrial carcinoma in Kenya.
Methods: This protocol was developed using a guideline adaptation approach that aligned high-quality international guidelines with Kenya’s health system and resource context. A multidisciplinary panel comprising gynecologic oncologists, pathologists, radiologists, oncology nurses, pharmacists, radiation oncologists, public health specialists, and patient representatives led the process. Panel members received technical training from the University of Nairobi and Kenyatta National Hospital on evidence-based adaptation methods, including standardized appraisal, systematic evaluation of guidelines, and contextualization to local needs. A systematic literature search of PubMed and Google Scholar was conducted. Five guidelines were retrieved and independently appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Three guidelines were selected for adaptation: the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology: Uterine Neoplasms, Version 3.2025; the Pan-Asian adapted European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the Diagnosis, Treatment, and Follow-up of Patients with Endometrial Cancer (2022); and the European Society of Gynaecological Oncology (ESGO), European Society for Radiotherapy and Oncology (ESTRO), and European Society of Pathology (ESP) guidelines for the management of patients with endometrial carcinoma (2020). The selected guidelines were reviewed and contextualized to Kenya’s resource setting and healthcare infrastructure.
Results: The protocol provides recommendations for the diagnosis, staging, pathological assessment, preoperative evaluation, surgical management, and adjuvant treatment of endometrial carcinoma. It also addresses management according to disease stage, histological subtype, and risk stratification; fertility-sparing treatment; recurrent disease; post-treatment surveillance; supportive care; and targeted therapies. Molecular classification and contemporary systemic therapies, including immunotherapy, are addressed within the Kenyan healthcare context.
Recommendations: The protocol provides a standardized, evidence-informed framework for the management of endometrial carcinoma in Kenya. It aims to improve consistency in clinical decision-making across the continuum of care, support appropriate use of available resources, and promote equitable access to evidence-based management.
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Copyright (c) 2026 Dr. Stella N. Njenga, Dr. Victor T. Otieno, Prof. Jacqueline J. Chesang', Dr. Benjamin E. Odongo, Dr. Millicent S. Masinde, Dr. Alfred Mokomba, Dr. Wycliffe Musalia, Prof. Rose J. Kosgei, Dr. Isaac M. Maingi, Dr. Bruce O. Semo, Dr. Steven M. Ibua, Dr. Simon M. Gitau, Dr. Gideon M. Mutua, Dr. Diana Marion, Dr. Naomi N. Sitati, Dr. Anwar Z. Mohamed, Prof. Eunice J. Cheserem, Dr. Margaret K. Kilonzo, Dr. Innocent O. Maranga
This work is licensed under a Creative Commons Attribution 4.0 International License.
